CORONAVIRUS (COVID-19)
(updated 12/15/2022)

If you have symptoms suggestive of COVID-19, please stay home. 

EVERYONE SHOULD GET THE VACCINE (prefer mRNA vaccine)
Monovalent vaccine should still be used for the primary dose
Bivalent vaccine should be used for any booster dosing
You are eligible for the current bivalent booster dose if your most recent booster dose was at least 2 months ago.
If you had a recent COVID-19 infection, it is preferable to wait 3 months prior to getting a booster dose

To ensure the best antibody response to the vaccine, please read the following guidelines regarding what to do with medications used to treat your rheumatic disease (ACR guidelines)
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Medication                                                       Timing consideration for Immunomodulatory therapy and COVID-19 vaccination
                                                                                        (for primary and booster doses)

Abatacept  (Orencia) IV 
​Belimumab (Benlysta) IV                                  Time vaccine one week prior to next dose

Abatacept (Orencia) subcu                               Hold medication for 1-2 doses AFTER each dose of COVID vaccine
Belimumab (Benlysta) subcu                                 if rheumatic disease is well controlled

Acetaminophen, NSAIDs                                Hold for 24 hours prior to vaccine; ok to take meds after vaccine for symptoms/side-effects

Hydroxychloroquine, IVIG
TNFi, IL-6R, IL-1R, IL-17, IL12/23, IL-23                        No need to interrupt therapy
and other cytokine inhibitors

Cyclophosphamide IV                                       Time infusion to one week after each vaccine dose

Rituxan(and any anti-CD20)                                     Discuss timing of vaccine with provider

All other therapy not listed above    
- Apremilast (Otezla), Methotrexate,                          Hold medication for 1-2 weeks AFTER each dose of COVID vaccine 
Azathioprine (Imuran), Leflunomide (Arava)                            if rheumatic disease is well controlled
Mycophenolate/Cellcept, oral cyclophosphamide,
calcineurin inhibitors, Sulfasalazine, JAKi (Xeljanz
Rinvoq, Olumiant)

If your rheumatic disease is not well controlled, please call the office BEFORE you stop your medications

​CDC strongly recommends that close contacts of immunocompromised people be vaccinated against COVID-19

EVUSHELD:
The U.S. Food and Drug Administration has issued an EUA for the emergency use of the unapproved product EVUSHELD (tixagevimab co-packaged with cilgavimab), for the pre-exposure prophylaxis of COVID-19 in adults and pediatric individuals (12 years of age and older weighing at least 40 kg):
 Who are not currently infected with SARS-CoV-2 and who have not had a known recent exposure to an individual infected with SARSCoV-2 and
 Who have moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments and may not mount an adequate immune response to COVID-19 vaccination
or
 For whom vaccination with any available COVID-19 vaccine, according to the approved or authorized schedule, is not recommended due to a history of severe adverse reaction to a COVID-19 vaccine(s) and/or COVID-19 vaccine component(s).

After any dose of COVID-19 vaccine, wait 2 weeks prior to getting EVUSHELD injection; after EVUSHELD injection, you may get your booster dose of COVID-19 vaccine without any wait.

You may receive the COVID-19 booster dose and flu shot on the same day
​